Laura's Law: Where the mayoral candidates stand

MENTAL HEALTH

Published 4:00 am, Sunday, October 23, 2011

Laura's Law was passed by the Legislature in 2002 after Laura Wilcox, a young woman in Nevada County, was killed by a mentally ill man who had refused treatment. The law allows for court-ordered assisted outpatient treatment for individuals who pose a threat to themselves or others. Implementation, however, was left up to each county. To date, only Nevada and (on a limited basis) Los Angeles counties have chosen to adopt an outpatient commitment program to ensure that an individual is provided with medical services and treatment, including medication.

As part of The Chronicle's endorsement research, we asked the candidates for San Francisco mayor to answer this question: Do you support implementation of Laura's Law? The answers were edited for length. To read the full text, go to www.sfgate.com/sfmayor2011/

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I support the implementation of Laura's Law. As public defender, I have had extensive experience dealing with individuals who have varying degrees of mental illness. While it is important to preserve the individual liberties of our citizens, in appropriate cases court-ordered supervised mental health treatment can be the best option. I would work to ensure that the implementation of Laura's Law would not violate the civil rights of the mentally ill. I would also seek to increase funding for voluntary treatment resources. Every day, mentally ill San Franciscans are turned away from supportive housing and community mental health clinics because of funding cuts. As mayor, I will prioritize funding for cost-effective, humane, community-based mental health treatment.

I do. I believe that assisted outpatient treatment programs and our Behavioral Court system should be available to both families and individuals outside of our prison system. Studies have shown outpatient programs to be both a more effective and less expensive way to help people with severe cases of mental illness.

No, because we can only implement Laura's Law if such a law would not undercut current public health services. According to the San Francisco Public Health Department, Laura's Law would have a huge impact on its budget and would displace current services.

I am deeply supportive of the intention behind Laura's Law and of the spirit of pragmatic experimentation that underlies the support for local implementation of it. But I do not support implementing it in San Francisco without a modification that would make it more likely to succeed. My position is based on the public advice of the widely respected former San Francisco public health director, Mitch Katz. Last year, he told the Board of Supervisors that "(P)sychosis requires medication and Laura's Law does not increase our ability to require medication. There is a basic ethical principle in public health. (The) ethical principle is not infringing on someone's rights unless you have an efficacious treatment. And because Laura's Law doesn't allow for medication, I do not believe it fulfills that ethical principle."

Yes. To my knowledge, I am the only supervisor over the past 10 years who agreed to serve on the city's Mental Health Board. Laura's Law is a big step forward in mental health care. A study of the New York version (Kendra's Law) in 2005 found that the law brought about enormous savings for the state and had measurable long-term benefits. Funding from the Mental Health Services Act (Prop. 63) can be used for Laura's Law, as Nevada and Los Angeles counties are doing.

Yes, but the political and policy-making realities of San Francisco demand that the next mayor take a cautious, constructive and inclusive approach among community advocates and stakeholders to implement the law. Laura's Law is a reasonable provision for court-ordered assisted outpatient treatment for individuals with serious mental illnesses that make them a threat to themselves or others.

Laura's Law is well-intentioned, intended to create an involuntary outpatient mental health treatment program modeled after the so-called Kendra's Law in New York. Unfortunately, Laura's Law had several problems:

1. It does not allow forced medications (an essential part of a successful program);

2. It does not allow the judge to force clients to stay in treatment if they don't want to;

3. There was no funding attached and a stipulation that no voluntary programs could be defunded to support it.

To move beyond the status quo, San Francisco instead has begun a pilot project to assist persons who meet the criteria to live in our community in the least restrictive setting, to provide community outreach and resources and to assist individuals to maintain independence and stability. We will evaluate this pilot next year for effectiveness.

Joanna Rees

Yes, I support implementation of Laura's Law. We need to focus on treatment of mental illness and putting people on a path to self-sustainability, not to incarceration. Implementation of this law will prevent those with severe mental disability from harming themselves or others.

I support the implementation of Laura's Law. This key piece of legislation supports the efforts of cities and our Reset San Francisco community, which are working to keep the streets safe by compelling those who need mental health treatment to receive treatment. I understand the concerns of civil libertarians on this issue. But for the safety of the individuals themselves and certainly for the safety of the entire community, there are some people who should be required to participate in the treatment they need to stay well.

I fully support the implementation of Laura's Law in San Francisco. In 2006, I authored the bill to reauthorize Laura's Law at the state level. In 2009, I authored a bill that would have removed a number of costly and burdensome requirements in Laura's Law and allowed San Francisco (and other counties that choose to do so) the flexibility to implement the law using existing mental health services rather than establishing a brand new program.

Laura's Law would allow us to treat the most seriously ill and dangerous patients, many of whom spend their lives homeless, before their lives collapse or they harm themselves or others. Treating mental illness early is not only in the best interest of the patient, but the best interest of the city; early treatment is far more cost-effective than allowing these individuals to end up in homeless shelters, emergency rooms or jail.

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